{$error_msg}
<form action="{$request_uri}" method="post" accept-charset="UTF-8">
	<fieldset>
		<dl>
			<dt><label for="index_name">{lang values="pages|index_name"}</label> <span>({lang values="pages|index_name_description"})</span></dt>
			<dd><input type="text" name="form[index_name]" id="index_name" value="{$form.index_name}" maxlength="20" /></dd>
			<dt><label for="title">{lang values="pages|block_title"}</label></dt>
			<dd><input type="text" name="form[title]" id="title" value="{$form.title}" maxlength="120" /></dd>
		</dl>
	</fieldset>
	<div style="margin-top:20px">
		<input type="submit" name="submit" value="{lang values="common|submit"}" class="form" />
	</div>
</form>